Vocal cord paralysis following carotid endarterectomy: the paradox of return of function.
In a series of 411 consecutive carotid endarterectomies 29 patients were identified with vocal cord paralysis. All patients were symptomatic, although in many these symptoms were subtle and rapidly resolved. There was a statistically significant predominance of left-sided paralysis. Excluding three patients who died during the initial year of follow-up return of normal voice was noted in 22 patients, but complete return of vocal cord function was present in only 15. Apposition of the contralateral vocal cord against a paralyzed vocal cord allowed for production of normal voice in five patients. Less than 1% of patients remained with symptoms at one year following endarterectomy. We conclude that vocal cord paralysis is a common complication of carotid endarterectomy; the voice becomes an unreliable guide as to its resolution. We recommend laryngoscopic examination of all patients who undergo bilateral carotid endarterectomy.
Sannella
N A
NA
Tober
R L
RL
Cipro
R P
RP
Pedicino
J F
JF
Donovan
E
E
Gabriel
N
N
D002340:Carotid Artery Diseases / Q000601:surgery*; D004691:Endarterectomy / Q000009:adverse effects*; D007839:Functional Laterality; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D061224:Laryngeal Nerve Injuries; D012075:Remission, Spontaneous; D013997:Time Factors; D014826:Vocal Cord Paralysis / Q000209:etiology* / Q000534:rehabilitation; D014827:Vocal Cords / Q000294:innervation*